The Pregnancy Mask: Melasma

If during or after your pregnancy, you notice brown to brownish-gray patches –primarily on the forehead, cheeks, nose, upper lip, and chin, then you may have melasma.1,2,3 Usually, melasma develops slowly and is symmetrical on the face.1,2 It can occur in women and men with any skin type; however, it most commonly affects women.1,2 It is estimated that melasma affects more than six million women in the United States.4

Melasma is not relate to skin cancer (melanoma) – it will not turn into cancer, and it does not increase your risk of skin cancer.

Why does it occur during pregnancy?

Melasma, also known as chloasma, is commonly referred to as “the mask of pregnancy.” One theory as to why melasma frequently occurs during pregnancy is due to hormonal changes, but the exact cause is unclear.1,2 If you are pregnant and have melasma, then rest assured that it usually fades on its own within a few months after the baby is born.1,2 Other factors that may cause melasma include:1

genetics

using oral contraceptives

using a hormone replacement medication

endocrine dysfunction (e.g., thyroid problems)

UV light exposure

certain cosmetics

How can melasma be prevented?

The key step that you can do to reduce your risk of melasma is to avoid sun exposure, as sunlight can trigger it.3,4 Ideally, use a broad spectrum sunscreen daily that blocks both UVA and UVB rays –a sunscreen with a sun protection factor (SPF) of 30 or greater – and wear a wide-brimmed hat when outside.3,4 The American Academy of Dermatology (AAD) recommends using sunscreen throughout the year, and not just during sunny days, to reduce the risk of melasma reoccurring. 3,4 The AAD also recommends to avoid waxing areas affected by melasma as it can cause irritation.4

How can melasma be treated?

If your melasma does not fade several months after your baby is born, consult your dermatologist about topical treatment options. “Hydroquinone is sometimes used to treat melasma, but it is not recommended during pregnancy or breastfeeding,” states Dr. Robyn James, a dermatologist, “some skin lightening agents such as azelaic acid gel and soy based agents have an acceptable safety profile for pregnant women.” Alternatively, a dermatologist may recommend a chemical peel or a laser procedure to treat your condition.3

Summary

Hormonal changes and sun exposure can cause melasma in women during and post-pregnancy. It usually resolves soon after the baby is born, but in some cases it can persist for a longer period. Your dermatologist can recommend the best treatment plan based on your condition, which may include a topical medication or a clinical procedure. If you are pregnant or breast-feeding, consult your health care provider before using a topical medication or chemical peel to treat your melasma.References

Jackie Kostick PharmD is a pharmacist, medical/science writer, and mother of two children. She has written and researched pharmacy-related material --medical newsletters, drug monographs, medical/science website content-- for organizations including Medscape, the American Society of Health-System Pharmacists (ASHP), CVS/Caremark, and United HealthCare.